Bella Vista Dentistry (719) 593-9182
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**Please click the link below to print the complete Authorization to Release Dental Records. 

 Be sure to fill out both pages and return them to our office.**

authorization_for_the_release_of_dental_records.doc
File Size: 34 kb
File Type: doc
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  • Home
  • Our Services
  • Dr. Levasseur
  • Staff
    • Gail - Office Manager
    • Susan - Dental Assistant
    • Pam - Dental Hygienist
  • Patient Information
    • Glossary of Dental Terms
    • New Patient Forms
    • Financial Options
    • Records Release Authorization
    • Colorado Marijuana Law
    • Why We Went Paperless
  • Office Tour
  • Map
  • Office Information
  • Home
  • Our Services
  • Dr. Levasseur
  • Staff
    • Gail - Office Manager
    • Susan - Dental Assistant
    • Pam - Dental Hygienist
  • Patient Information
    • Glossary of Dental Terms
    • New Patient Forms
    • Financial Options
    • Records Release Authorization
    • Colorado Marijuana Law
    • Why We Went Paperless
  • Office Tour
  • Map
  • Office Information